What It Is, How It Works, and Why You Should Care€¦ · What It Is, How It Works, and Why You...

1

Community Water Fluoridation:

What It Is, How It Works, and

Why You Should Care

William Maas, DDS, MPH

Kristen Mizzi

The Pew Charitable Trusts Children’s Dental Campaign

January 29, 2014

2

Tooth decay remains the most common chronic childhood disease

3

• Average annual dental expenditures for privately insured individuals:

– 0-20 years old: $358

– 21-64 years old: $582

• Preventable dental conditions were the primary diagnosis in 830,000+ visits to hospital ERs nationwide in 2009 — a 16% increase from 2006.

Tooth decay is expensive to treat

4

A person could spend more than $6,000 over a lifetime to

deal with the consequences of a cavity in just one molar

Tooth decay is expensive to treat

5

Tooth decay is preventable

because of access to fluoride

6

What is Fluoridation?

Fluoridation is the adjustment of the fluoride in drinking water to the optimal level for reducing tooth decay

7

In 1945, communities in Michigan , New York, and Ontario were the first to fluoridate their water

supplies

Today, communities across the country adjust the level of fluoride in their water systems to

protect public health

8

U.S. Task Force on Community Preventive Services

strongly recommends CWF

• Updated April 2013

Fluoridation Prevents Tooth Decay

9

Fluoridation Works Throughout the Lifespan

11/5/2013

“Fluoridation is the single most effective public health measure to prevent tooth decay and improve oral health over a lifetime, for both children and adults.”

David Satcher, MD, PhD Surgeon General (1998-2002)

10

Fluoridation reduces tooth decay about 25%

11

Fluoridation still works in the U.S. … even in communities where children brush with fluoridated

toothpaste and get fluoride treatments at the dentist.

National survey of 40,000 schoolchildren:

– Almost all toothpaste had fluoride

– Twice annual fluoride treatments were common

Findings:

– Regional data demonstrated “halo effect”

12

Fluoridation: Still Vital, After All These Years

“Community water fluoridation continues to be a vital, cost-effective method of preventing dental caries.”

Regina M. Benjamin, MD, MBA Surgeon General (2009-2013)

13

26%

37%

50% 56%

58%

0%

10%

20%

30%

40%

50%

60%

70%

80%

% C

ari

es-

Fre

e

1971-73 1979-80 1986-87 1988-94 1999-2002Source: National Survey Findings

Ages 5-17 years Ages 6-19 years

Trends in Cavity-Free School Children (Permanent Teeth)

14

Fluoridation is Safe

• The Environmental Protection Agency (EPA) is

responsible for regulating public drinking water and

enforcing the Safe Drinking Water Act.

• The EPA does not have a position per se on the

fluoridation, only on the level of fluoride in the

drinking water.

• Fluoride occurs in U.S. water supplies at levels from

0.1 to 8.0 mg/L or parts per million (ppm).

• The EPA does not permit levels above 4.0 mg/L to

be used for drinking water.

15

National Research Council has Weighed and Debated all the Evidence • The EPA is guided by the National Research Council

NRC, for fluoride and other issues.

• No findings of the 2006 NRC report question the safety of fluoride at 0.7-1.2 mg/L.

• Know the four page Report in Brief.

• Future EPA action will address severe dental fluorosis, the well known adverse health effect of 2-4 mg/L, not the imagined health effects claimed by opponents.

16

17

Fluoridation is Equitable

18

Every $1 invested in water fluoridation

Saves $38 in unnecessary dental costs

Fluoridation is Cost-effective

19

“Fluoridation is the single most important commitment a community can make to the oral health of its children and to future generations.” Dr. C. Everett Koop Surgeon General (1982-1989)

Fluoridation is Cost-effective

20

0%

10%

20%

30%

40%

50%

60%

70%

80%

1951 1953 1955 1957 1959 1961 1963 1965 1969 1980 1988 1992 2002 2010

US Fluoridation Rate

21

22

Despite progress, much work remains About a third of Americans still don’t have

access to fluoridated water

23

Sugar Bacteria

Water + Fluoride + Saliva

Re-mineralizes enamel De-mineralizes enamel

How Fluoride in water works

24

“Halo Effect” Shipped to

non-fluoridated communities

Products processed in fluoridated communities

25

Non-fluoridated

Communities: Some Benefits

Fluoridated Communities: Greatest Benefits

“Halo Effect”

26

Fluorosis: Old Issue, Better Understanding

“Colorado Brown Stain”

27

Dental Fluorosis (severe) Dental Fluorosis (mild)

Fluorosis: Old Issue, Better Understanding

28

Fluoridation Still Matters

29

What are we up against?

30

Be proactive and attuned to your community

• Find out who is in charge

• Establish yourself as an expert

• Educate your community

• Connect with partners

31

What happens here matters

32

Don’t be afraid to take the first step

33

National campaign to support local fluoridation efforts

34

http://www.ilikemyteeth.org

35

“The materials produced by the Pew coalition have proven to be a great resource for fighting to preserve water fluoridation.”

– Florida dentist

“On Tuesday night, the town of Bradford voted to reinstate fluoridation, thanks in large part to the eloquent speech of one of the selectmen who had read your website. Also, I relied heavily on your website to put together a PowerPoint presentation . . . Thank you for your great work!”

– Vermont health official

36

Partners

37

@ILikeMyTeeth #fluoride

38

http://www.nnoha.org/resources/advocacy/cwf/

39

Thank you! Questions?

40

Contact: Bill Maas, bmaas@pewtrusts.org

Kristen Mizzi, kmizzi@pewtrusts.org

Keep Informed:

of these and other oral health issues by receiving Pew's monthly e-newsletter – Dental News & Views.

Send an email to Mary McNamara,

mmcnamara@pewtrusts.org with the words “Sign me up“ in the subject line.